Infected Silicone Chin Implant After Implant-Supported Jaw Rehabilitation: Case Report and Literature Review.

This paper reports on an infected silicone chin implant due to the nonideal placement of dental implants, in a female patient aged 67 years old. A patient unsatisfied with her facial profile had received a silicone chin implant 25 years ago and had recently undergone surgery for placement of dental implants in a region close to the silicone implant. The nonideal positioning of dental implants and close contact with the silicone implant led to the absence of osseointegration, with consequent mobility and infection of both. The mobile dental implants and silicone implant were removed. Imaging exams revealed other complications of the silicone implant as bone resorption and formation of a narrow bone layer around the inferior silicone implant border. Alloplastic implants are an option for the esthetic correction of chin deformities. Solid silicone is biocompatible and highly resistant to degradation, with minimal allergic reaction and risk of toxicity. However, several postoperative complications may arise, such as migration or displacement, extrusion, foreign body reaction, bone resorption, heterotopic bone formation, and infection. Precise imaging exams are critical for diagnosis and to indicate the best treatment plan.

Bovine and equine biomaterials in mandibular alveolar dog model: split-mouth study / Biomateriais de origem bovina e equina em alvéolos mandibulares de cães: estudo boca-dividida

A predictable rehabilitation of severely atrophied alveolar ridge defects still remains a matter of concern in implant dentistry. Objective: The aim of this study was to compare histologically biomaterials of bovine (Genox®) and equine (Bio-Gen®) origin associated or not to platelet-rich plasma (PRP), analyzing bone maturity, amount of mature (type I) and immature (type III) collagen present at sixty and ninety days in post-extraction alveolus. Materials and Methods: Four Beagle dogs were used from which the six mandibular premolars were extracted. The alveolus contained respectively: right side, BioGen ® (group B), preserved the clot (group C), Genox ® (group G); left side, Bio-Gen ® + PRP group (BP), Clot + PRP (group CP) and Genox ® + PRP (group GP). After sixty and ninety days, two dogs were sacrificed at each date and the pieces were histologically processed and stained with picrosirius red, a specific stain for analysis of different types of collagen. Results: Comparisons of the averages of mature collagen at 60 days indicated significant differences between Group G when compared to Groups C and B. The biomaterial of bovine origin demonstrated higher amounts of mature collagen in 90 days while the biomaterial of equine origin had a higher average of immature collagen in 90 days. Conclusion: Groups associated to PRP were effective in the production of mature and immature collagen. Genox® associated with PRP demonstrated a more advanced stage of bone regeneration presenting as an alternative to fill post-extraction alveolus.

Reabilitar defeitos ósseos alveolares severamente atrofiados de forma previsível continua a ser um motivo de preocupação em implantodontia. Objetivo: O objetivo deste estudo foi comparar, histologicamente, biomateriais de origem bovina (GenOx®) e equina (Bio-Gen®) associados ou não ao plasma rico em plaquetas (PRP), analisando a maturidade óssea pela quantidade de colágeno maduro (tipo I) e imaturo (tipo III) presentes em alvéolos pós-exodontia no acompanhamento de 60 e 90 dias. Materiais e Métodos: Foram utilizados quatro cães da raça Beagle, dos quais foram extraídos os seis pré-molares da mandíbula. Os alvéolos continham, respectivamente: lado direito - Bio-Gen® (grupo B), coágulo (grupo C), GenOx® (grupo G); lado esquerdo - Bio-Gen® associado ao PRP (grupo BP), coágulo associado ao PRP (grupo CP) e GenOx® associado ao PRP (grupo GP). Depois de 60 e 90 dias, dois cães foram sacrificados em cada data e as peças foram histologicamente processadas e coradas por picrosirius red, um corante específico para análise de diferentes tipos de colágeno. Resultados: Comparações entre as médias de colágeno maduro em 60 dias indicaram diferenças significantes entre o Grupo G quando comparado aos Grupos C e B. O biomaterial de origem bovina apresentou maior quantidade de colágeno maduro em 90 dias, ao passo que o biomaterial de origem equina apresentou alto índice de colágeno imaturo em 90 dias. Conclusão: Grupos associados ao PRP se mostraram eficazes para a maior produção de colágeno maduro e imaturo. O GenOx® associado ao PRP apresentou estágio mais avançado de regeneração óssea, sendo uma alternativa para preenchimentos de alvéolos pós-exodontia.

Evaluation of biomaterials with and without platelet-rich plasma: a histometric study using beagle dogs

Aim: To compare the alveolar bone repair process using biomaterial in dogs with and without the incorporation of platelet-rich plasma. Methods: Six beagles were used. Bilateral extractions of the three mandibular premolars were performed. Bio-Gen® was applied in the first alveolus, the clotwas maintained in the second alveolus and Genox® was applied to the third alveolus. PRP wasadded to all alveoli on the left side only. The dogs were submitted to euthanasia after 30, 60 and90 days and submitted to histological analysis for the determination of mean area of new boneformation. Tukey’s post test was used in the statistical analysis. Results: Significant increase inbone formation occurred in Bio-Gen® + PRP when compared with the other groups at 30 and 90days. In the evaluation at 60 days, no statistically significant differences among the groups were found. Conclusions: The Bio-Gen® biomaterial led to the best bone repair and the combinationof platelet-rich plasma accelerated the repair process.

O uso de biomateriais de origem bovina e equina, associados ou não ao plasma rico em plaquetas, em alvéolos mandibulares de cães: estudo split-mouth com análise quantitativa / The use of bovine and equine biomaterials associated or not to platelet-rich plasma in mandibular alveolar dog model: a quantitative analysis

Objetivo: avaliar biomateriais de origem equina (Bio-Gen) e bovina (Genox), associados ou não ao plasma rico em plaquetas (PRP). Material e métodos: seis cães Beagle, fêmeas (entre dois e três anos de idade, pesando 10 kg), tiveram seis pré-molares mandibulares extraídos. No lado direito, os alvéolos receberam Bio-Gen (B), coágulo (C) e Genox (G); no lado esquerdo, o PRP foi adicionado em cada grupo (BP, CP e GP). Após 30, 60 e 90 dias, dois cães foram sacrificados em cada período, e as peças foram processadas. As imagens microscópicas e a contagem dos osteoblastos aderidos às trabéculas ósseas e osteócitos presentes em lacunas no tecido ósseo neoformado foram realizadas pelo mesmo operador. Os testes Anova e Tukey (nível de significância de 5%) foram empregados na análise estatística. Resultados: para a contagem de osteoblastos, aos 30 dias, houve diferença estatisticamente significante dos grupos G e GP, quando comparados aos grupos B, BP, C e CP (p < 0,05). Na análise de 60 dias, os grupos BP e GP apresentaram diferença estatisticamente significativa, quando comparados aos grupos B (p < 0,001) e G (p < 0,000001), respectivamente. Para a contagem de osteócitos, aos 30 dias, houve diferença estatisticamente significante quando os grupos BP e GP foram comparados aos grupos B (p < 0,00001) e G (p < 0,002), respectivamente. Os grupos GP e G apresentaram diferença estatisticamente significativa entre si, em 60 dias (p < 0,0009) e 90 dias (p < 0,0004). Conclusão: o grupo GP apresentou maior quantidade de osteócitos e osteoblastos em todos os períodos analisados, sendo considerado o mais efetivo para a neoformação óssea.

Uso do PRP com enxertos autógeno e de banco de tecido ósseo para levantamento do seio maxilar em um modelo em cães: desenho tipo split-mouth com resultados microscópico / The use of PRP with autogenous and tissue bone bank grafting for sinus lift procedures in the dog model: split-mouth design with microscopic results

Objetivo: avaliar microscopicamente a contribuição do plasma rico em plaquetas (PRP) no processo de reparo do enxerto ósseo de banco de ossos humanos e de osso autógeno em seios maxilares de cães. Material e métodos: quatro cães da raça Beagle, com dois anos de idade e aproximadamente 10 kg, foram submetidos a cirurgias de levantamento de seio maxilar utilizando-se enxerto ósseo autógeno (lado direito) como grupo-controle e enxerto de banco de ossos humanos (lado esquerdo) associados ao PRP em dois cães, e sem nos outros. As amostras para análise foram removidas com broca trefina no período de 60 dias pós-enxertia. Resultados: o enxerto autógeno mostrou processo de reparo em desenvolvimento; quando associado ao PRP apresentou organização lamelar e presença de medula óssea. No enxerto alógeno foram observadas fibrilas colágenas desorganizadas com grande quantidade de osteócitos; quando associado ao PRP, notou-se ausência de infiltrado inflamatório e processo de reparo em fase final. Conclusão: 1) através da análise histológica, o processo de ossificação do enxerto autógeno associado ao PRP foi superior; 2) a associação do PRP ao enxerto de banco de ossos humanos demonstrou reparo ósseo superior, quando comparado ao enxerto autógeno utilizado isoladamente.

Objectives: to microscopically evaluate the contribution of Platelet Rich Plasma (PRP) in the process of repairing bone human bones graft stock and autogenous bone in maxillary sinus of dogs. Material and methods: four Beagle dogs, aged 2 years old and about 10 pounds underwent maxillary sinus surgery using autogenous bone graft (right) as a control group and grafting of human bone bank (hand left) associated with the PRP in two dogs, and no other. Samples for analysis were removed with trephine drill within 60 days after grafting. Results: the autograft showed the repair process in development, when combined with PRP showed lamellar organization and the presence of bone marrow. In the allograft was observed disorganized collagen fibrils with loads of osteocytes, and when combined with PRP, it was noted the absence of inflammatory infiltrate, and repair process in the final stage. Conclusion: 1) by histological analysis, the process of ossification of the autogenous PRP was associated with higher; 2) association of PRP to the graft database of human bones showed higher bone healing compared to autograft used alone.

Effect of mechanical loading on the removal torque of different types of tapered connection abutments for dental implants.

STATEMENT OF PROBLEM: The mechanical behavior of internal taper implant abutment designs needs to be evaluated. PURPOSE: The purpose of this study was to evaluate the effect of simulated mechanical loading on the removal torque of 1-piece and 2-piece abutments connected to internal taper oral implants. MATERIAL AND METHODS: Forty-eight internally notched taper implants were divided into 2 groups of 24. Group OP received solid (1-piece) abutments; group TP received esthetic (2-piece) abutments. Each group was further subdivided into subgroups C (control) without mechanical loading and T (test) with mechanical loading. In groups OPC and TPC, the abutments were placed and removed and the removal torque values (RTVs) registered. In groups OPT and TPT, abutments were placed, mechanically loaded (500 000 cycles), removed, and the RTVs registered. Groups TPC and TPT were further tested for the traction force necessary to dislodge the abutment from the implant. For data analysis, the Student t test (for RTVs) and the Mann-Whitney U test (for TFVs) (α=.05) were performed. RESULTS: All abutments tested presented torque loss with RTVs lower than the placement torque. A statistically significant difference (P=.002) was found between groups OPC (81.6% of placement torque) and OPT mean RTVs results (85.0% of placement torque), while no statistical differences (P=.362) were found between groups TPC (63.7% of placement torque) and TPT (59.1% of placement torque). The traction force values necessary to dislodge the abutment from the implant, however, were significantly higher (P<.001) for group TPT than for group TPC. CONCLUSIONS: Cold welding did not occur in any of the abutment specimens tested. Even after the mechanical loading, esthetic abutments presented similar RTVs. The traction force necessary to remove esthetic abutments from inside the implants presented a 2-fold increase after mechanical loading.

Hipertratamento de miíase decorrente de trauma facial complexo / Treatment of myiasis resulting from complex facial trauma

Miíase é uma infestação em tecidos e órgãos ou ocasionada por larvas de dípteros, em humanos ou em animais, por depositarem os seus ovos em tecidos do corpo. Acomete, na maioria das vezes, pessoas de nível socioeconômico baixo, de regiões de clima tropical, imunocomprometidas e com desordens psiquiátricas. Devido ao grande potencial destrutivo, prevenção e tratamento apropriado em tempo hábil são necessários. Apresentamos um caso de miíase em paciente vítima de acidente automobilístico há 08 dias, o qual apresentava múltiplas fraturas e extensos ferimentos faciais não tratados devido à difícil localização e falta de estrutura hospitalar locais. Os ferimentos em face estavam infestados por larvas do díptero Cochliomyia hominivorax spp. As fraturas foram tratadas cirurgicamente, e os tecidos infestados pelas larvas, por meio do debridamento cirúrgico e terapia com o antiparasitário ivermectina.

Myiasis is an infestation of tissues and organs caused by Diptera larvae, in humans or animals, when they deposit their eggs on body tissues. It affects mostly people living in poor socioeconomic conditions in tropical regions, who are immunocompromised and suffering from psychiatric disorders. Due to the great destructive potential of myiasis, its prevention and timely appropriate treatment are of the utmost importance. We present a case of myiasis in a patient involved in a road accident eight days previously, who had multiple fractures and extensive facial injuries not treated because of the difficult location and lack of local hospital facilities. The wounds in the face were infested by Diptera larvae of Cochliomyia hominivorax spp. The fractures were treated surgically and larva-infected tissues infested by surgical debridement and therapy using the antiparasitic drug ivermectin.

O uso de osso equino (Bio-gen) e bovino (Genox) associados ou não ao PRP em alvéolos mandibulares de cães: desenho split-mouth com análise histológica / The use of equine (Bio-gen) and bovine (Genox) bones associated or not to PRP in the mandibular alveolar dog model: split-mouth design and histological analysis

O objetivo deste estudo foi avaliar histologicamente dois biomateriais (Genox e Bio-gen) associados ou não ao PRP e implantados em alvéolos mandibulares. Quatro cães da raça Beagle foram selecionados, entre dois a três anos de idade e pesando aproximadamente dez quilos. Extraiu-se os três pré-molares mandibulares de ambos os lados e imediatamente os alvéolos foram preenchidos, respectivamente: lado direito, no primeiro alvéolo foi aplicado Bio-gen (grupo 1), no segundo foi mantido coágulo (grupo 2) e no terceiro Genox (grupo 3); lado esquerdo, no primeiro alvéolo foi aplicado Bio-gen + PRP (grupo 4), no segundo coágulo + PRP (grupo 5) e no terceiro Genox + PRP (grupo 6). Após 30 dias, os animais foram sacrificados e realizou-se o processamento das peças cirúrgicas. Na análise histológica observou-se uma aceleração do processo de reparo nos grupos 4 e 6. Notou-se ainda que no grupo 4, o processo de reparo era o mais evoluído, apresentando um trabeculado ósseo mais maduro em comparação aos demais

The objective of this study was to evaluate bone repair with two biomaterials (Genox, Bio-gen) associated or not with the plasma-rich platelet (PRP) in the mandibular dog model. Four beagle dogs (2-3-years-old, 10 pounds each) had their first, second, and third premolars extracted and immediately filled on the right side with Bio-gen (Group 1), clot (Group 2), and Genox (Group 3). On the left side, the same was performed but with PRP (groups 4, 5, and 6). After thirty days, animals were sacrificed and processed for histological analysis. Acceleration of healing process was observed in groups 4 and 6. Further, Group 4 presented more mature trabecular bone when compared among groups

Surgical management of impacted teeth using three-dimensional computed tomography.

The surgical removal of impacted, supernumerary, or ectopic teeth is a routine procedure to the dental surgeon. Because any and all surgical interventions involve anatomic considerations that predispose the patient to a high risk of incidents or complications, it is absolutely necessary to precisely determine the location of the enclosed teeth, to better plan the procedure. Even though the conventional radiographic techniques are commonly used to detect the presence of such teeth, they can present deficiencies. In those situations, additional examinations can be requested. In this article, we are reporting the case of a 12-year-old patient, whose third superior molars appeared in a very atypical position. We chose to request a computed tomography and three-dimensional manipulation of the obtained images. This article, as its main goal, highlighted the importance of computed tomography and of three-dimensional reconstructions as a tool to precisely determine the location of enclosed teeth, thus allowing for a better planning of the surgery and a safer surgical intervention.

Reconstruction of frontal bone using specific implant polyether-ether-ketone.

Defects on the craniofacial complex may result in aesthetic defects, functional damage, and psychologic consequences. Previously, surgeons showed no interest in reconstructing the operated area, but in the treatment of the problem, leaving bone contour is a secondary issue. Nowadays, area reconstruction with post-reestablishment of contour and local shape has become one of the surgeon's priorities. The use of alloplastic implants with specific digital design has been stated to be an effective technique on the treatment of craniofacial defects, reducing the need for manipulation in the intraoperative period and decreasing surgery time. Polyether ether ketone (PEEK) is a potential candidate because it is a linear polyaromatic semicrystalline polymer that combines strength, stiffness, durability, and resistance. Polyether ether ketone biocompatibility has been supported in literature, and subsequent medical applications of the material have been observed. The aim of this study was to describe a case of frontal bone defect reconstruction in which the PEEK was used as polymer material in a specific implant for the Synthes (PEEK-PSI) patient.

Uso de fluoroscopia e tomografia computadorizada para remoção de agulha fraturada / Use of fluoroscopy and computed tomography for removal of broken needle

A anestesia local é fundamental no controle da dor em procedimentos odontológicos, porém a maioria das emergências ambulatoriais ocorrem durante ou imediatamente após a injeção do anestésico local. Dentre estes, podemos citar a fratura da agulha, que, apesar de incomum, pode ocorrer devido a uma técnica anestésica equivocada, ao uso de material de baixa qualidade ou à falta de colaboração do paciente. Após a fratura, o fragmento pode se mover através dos tecidos, necessitando de uma avaliação cuidadosa de um cirurgião buco-maxilo-facial antes da tentativa de recuperação desta. Várias técnicas de localização são descritas na literatura, como a tomografia computadorizada, panorâmica, detectores de metais, as radiografias convencionais e fluoroscopia transoperatória. O objetivo deste trabalho é apresentar uma breve revisão de literatura e relatar um caso de fratura de agulha em que a utilização da tomografia computadorizada de feixe cônico como um exame pré-operatório foi associada com fluoroscopia transoperatória para identificação e retirada de corpo estranho.

Local anesthesia is fundamental in pain control in dental procedures. Most emergencies in outpatient departments, however, occur during or immediately after the injection of local anesthetic. Among these we may mention needle fracture which, although uncommon, can occur because of an erroneous anesthetic technique, use of low-grade material or lack of cooperation on the part of the patient. After fracture, the fragment may move through the tissues, requiring careful evaluation by a maxillofacial surgeon before an attempt is made to recover it. Several location techniques are described in the literature, such as panoramic, computed tomography, metal detectors, conventional radiographs and intraoperative fluoroscopy. The aim of the present study is to review the literature and report a case of needle fracture in which the use of cone beam computed tomography as a preoperative examination was associated with fluoroscopy, perioperatively, for identification and removal of any foreign bodies.

Reconstrução de rebordo alveolar com osso homógeno em bloco: uma revisão sistemática / Alveolar ridge augmentation with homogenous bone block: a systematic review

A utilização de próteses implantossuportadas é, nos dias de hoje, uma alternativa segura e viável para reabilitação de áreas edêntulas. Porém, muitas vezes a instalação de implantes osseointegrados pode ser comprometida ou impossibilitada devido a reabsorções extensas dos rebordos alveolares. O objetivo deste trabalho foi revisar sistematicamente a literatura relacionada à reconstrução de rebordo alveolar com osso homógeno em bloco para subsequente instalação de implantes. O levantamento bibliográfico sistemático foi realizado na base de dados Pubmed e na Bibliografia Brasileira de Odontologia (BBO) entre os anos de 1966 e outubro de 2009. Além disso, foi realizada uma busca manual nas referências dos artigos incluídos na revisão. O resultado dessa revisão de literatura identificou apenas 7 estudos relacionados a essa técnica que preenchiam os critérios de inclusão. A espessura do rebordo aumentou significativamente com uso do enxerto homógeno, apresentando padrões de reabsorção dentro de limites aceitáveis. Os enxertos homógenos e os implantes instalados nas áreas enxertadas apresentaram altos índices de sucesso nos artigos incluídos. Esses demonstraram a previsibilidade da utilização dos enxertos homógenos e posterior instalação de implantes por um período de até 3 anos. No entanto, não há na literatura dados histológicos que confirmem existir uma osseointegração satisfatória com o uso desse material. São, portanto, necessários mais estudos controlados com avaliações histológicas para confirmar a eficiência e a segurança da utilização dos enxertos homógenos.

The use of implant-supported prosthesis is nowadays a safe alternative for rehabilitation of edentulous areas. But most of the time the implant placement can be compromised because of extensive alveolar resorption. The purpose of this study was to systematic review the literature related to the reconstruction of alveolar ridge with homogenous bone block for implant placement. The systematic review was performed on Pubmed and Brazilian Bibliography of Odontology (BBO) from 1966 to October 2009. Therefore, a hand-search in dental journals was done on the references of the selected articles. The results of this literature review identified only 7 studies related to this technique that filled the criteria of inclusion. The alveolar ridge width increased significantly with the use of block allograft, showing acceptable resorption standards. Allografts and implants inserted on grafted areas presented high success rates on the included articles. These ones showed the predictability of using allograft and implants placed after 3 years. However, there is no histological data on the literature that assures a satisfactory osseointegration using this kind of material. Controlled trials with histological evaluation are necessary to confirm the efficacy and security of allografts.

Osseointegrated implant fracture: causes and treatment.

Despite its high success rate, therapy with osseointegrated dental implants is not free of complications. Among the problems that may occur is fracture of implants, which, albeit a rare phenomenon, may lead to unpleasant clinical outcomes for the patient, as well as for the clinician. Thus, it is paramount to know the factors related to the biological processes involved in maintenance of osseointegration and biomechanics applied to dental implants to prevent such complications, as well as treatment options available to deal with the problem. Therefore, the objectives of this work were to investigate the literature to identify causative factors that may lead to fracture of dental implants and to discuss available procedures.

Use of biomaterials with or without platelet-rich plasma in postextraction sites: a microscopic study in dogs.

PURPOSE: Sites that will receive dental implants need to be quantitatively and qualitatively suitable for this therapy. The treatment of postextraction areas with biomaterials associated with platelet-rich plasma (PRP) might make the repair process more efficient, resulting in desirable bone characteristics. The present study sought to evaluate the effectiveness of PRP in the process of new bone formation when associated with biomaterials. MATERIALS AND METHODS: Four female dogs were used for this study. Mandibular postextraction sites received implants, along with bone substitutes (Bio-Oss [BO] or Biogran [BG]), on the right side of the mandible and these biomaterials plus PRP on the left side of the mandible. Thirty days later, the tissues were prepared and histologic analyses were carried out to compare the repair processes. RESULTS: PRP accelerated the repair process for both BO and BG; however, the action of PRP associated with BO did not surpass that of BG alone. CONCLUSIONS: The addition of PRP appears to accelerate the repair process.

Levantamento epidemiológico das fraturas do complexo zigomático no Serviço de Residência em Cirurgia e Traumatologia Bucomaxilofacial da UEM, no período de 2005 e 2006 / Epidemiological surveying of the fractures of the zigomatic complex in the Residence Service in Surgery and Bucomaxillofacial Traumatology of UEM in the period of 2005 to 2006

Neste trabalho, foi realizado um levantamento epidemiológico das fraturas do complexo zigomático no serviço de Cirurgia e Traumatologia Bucomaxilofacial da Universidade Estadual de Maringá - UEM, levando-se em conta os anos de 2005 e 2006. O objetivo deste trabalho consistiu em analisar aspectos destas ocorrências, como: gênero, idade, etiologia do trauma, classificação da fratura e tipo de tratamento. Nos 250 prontuários analisados, foram observadas 95 fraturas dos ossos zigomáticos, 49 fraturas nasais, 46 fraturas mandibulares, 31 fraturas maxilares e 29 foram classificadas como outras fraturas. Os pacientes mais afetados foram os do gênero masculino, na proporção de aproximadamente 2,5:1, na faixa etária entre 31 e 40 anos. As fraturas do zigomático foram classificadas segundo o grau de complexidade e divididas em classes de 1 a 5. A mais frequente foi a de classe 1. A etiologia mais frequente foram as agressões físicas, seguida dos acidentes de trânsito, em sua maioria causados por motos. O tratamento mais frequente foi o cirúrgico, com 55,84% dos casos, realizado com a utilização de fixação interna rígida, com placas e parafusos de titânio do sistema 1,5 e 2,0 mm.

In this work it was made an epidemiological research of the fractures of the zigomatic complex in the service of surgery and bucomaxillofacial traumatology of the Universidade Estadual de Maringá - UEM taking into account the period of 2005 and 2006. The analyzed aspects were:gender, age, etiology of the trauma, classification of the fracture and type of treatment. Of the 95 analyzed handbooks, it was observed 95 fractures of the zigomatic bone, 49 nasal fractures, 46 mandibular fractures, 31 maxillary fractures and 29 other fractures. The most affected patients were the male ones in the proportion of about 2.5:1, at the age of 31 to 40 years. The zigomatic fractures were classified according to degree complexity and divided into classes 1 through 5. Themost frequent was the class 1. The most frequent etiology was the physical assault followed by car crash, on its majority caused by motorcycles. The most frequent treatment was the surgical one,which took place with the utilization of rigid internal fixation with plates and screws of titanium of the 1.5 and 2.0 system.

Treatment of oral myiasis caused by Cochliomyia hominivorax: two cases treated with ivermectin.

The term myiasis is applied to the injurious action that larvae of certain diptera cause to the organism of vertebrate animals in the living or dead tissue in which they grow. Because of its great destructive potential, appropriate and preventative treatment are necessary. Among the sites of infestation, the human mouth is a common site, mainly in tropical countries. We present two cases of oral myiasis caused by Cochliomyia hominivorax spp. Ivermectin is an extremely effective semi-synthetic macrolides, in the treatment of this condition.

Deslocamento de terceiro molar superior para o seio Maxilar: relato de caso / Dislocation of an upper third molar into the maxillary sinus: a case report

O seio ou antro maxilar é a cavidade paranasal mais ampla, ocupando todo o corpo maxilar. Possui particularidadesanatômicas, sobretudo por sua íntima relação com as raízes dos pré-molares e molares superiores. A extração de terceiros molares superiores retidos é um procedimento cirúrgico comum, que pode acarretar complicações e acidentes como a comunicação acidental do seio maxilar com ou sem deslocamento do dente para seu interior. Relatamos o caso de um paciente de 38 anos que procurou serviço de Cirurgia e Traumatologia Buco-Maxilo-Facial da Universidade Estadual de Maringá após duas tentativas mal sucedidas de extração de terceiro molar superior que culminou com o deslocamento acidental do dente para o interior do seio maxilar. O dente foi removido com sucesso, utilizando-se como acesso a técnica de Caldwell-Luc. Este trabalho tem o objetivo de alertar o cirurgião-dentista quanto à importância de seu papel no diagnóstico, planejamento e remoção de terceiros molares, assim como mostrar uma complicação deste procedimento e seu tratamento.

The maxillary sinus or antrum is the largest paranasal cavity, occupying the entire maxillary body. It has anatomical particularities, above all its close relationship with the upper premolar and molar roots. The removal of an impacted upper third molar is a common surgical procedure and may produce complications or accidents, such as communication with the maxillary sinus and accidental dislocation of a tooth inside the sinus. We report the case of a 38-year-old patient treated in the Department of Oral and Maxillofacial Surgery, following two frustrated procedures to extract an upper third molar that was accidentally dislocated into the maxillary sinus. The surgical removal was successfully performed using the Caldwell-Luc access technique. The purpose of this paper is to alert the dentist to the importance of his or her role in the diagnosis, planning and surgical removal of third molars, and also to present a complication occurring during this procedure and its treatment.

Marsupialização de extenso queratocisto odontogênico em região anterior de mandíbula / Marsupialization of an extensive Odontogenic Keratocyst in the anterior mandibular region

O queratocisto é uma lesão de comportamento clínico e microscópico específicos. O tratamento pode ser descompressão, marsupialização e enucleação associadas a procedimentos auxiliares, já que essa lesão possui altas taxas de recidiva. O objetivo do trabalho é apresentar um caso clínico onde, o exame radiográfico, detectou-se uma extensa área radiolúcida unilocular na região anterior de mandíbula. A lesão foi marsupializada e a análise microscópica constatou um queratocisto odontogênico. Após um ano a lesão, com tamanho reduzido, foi enucleada. O paciente encontra-se em prosservação de cinco anos e não apresenta sinais clínicos e radiográficos de recidiva.

Induced hypotension in orthognathic surgery: a comparative study of 2 pharmacological protocols.

PURPOSE: The objective of this comparative study was to report on the use of 2 different pharmaceutical protocols involving 2 different anesthetic techniques (IV and balanced) to induce hypotension in patients submitted to orthognathic surgery by assessing the patients' intra- and postoperative physiologic response and hemodynamic stability. PATIENTS AND METHODS: Twenty ASA I patients, between 17 and 44 years of age who had dental and skeletal deformities were subdivided into 2 groups: group I (clonidine associated to remifentanil), and group II (dexmedetomidine associated to isoflurane), in addition, other drugs were common to both groups. The following responses were assessed: arterial blood pressure, heart rate, temperature during intra- and postoperative periods, incidence of nausea and vomiting, postoperative pain, awakening time, extubation time, and postanesthetic recovery time. RESULTS: The results of the study using Repeated Measures Test statistical analysis showed that there were no significant differences between the 2 groups in respect to physiologic responses or surgery time. CONCLUSION: Both protocols tried in this study proved to be effective and safe, and they seem to be interesting alternatives in longer orthognathic surgeries with the expectation of an important blood loss. The choice for either protocol should be based on the inherent risks involved in their use and their cost-benefit ratio.

Periimplantite: revisão de literatura / Peri-implantitis: literature review

A periimplantite é um processo inflamatório dos tecidos periimplantares associado à reabsorção óssea que pode levar à perda do implante. Este estudo tem como objetivo fazer uma revisão de literatura a respeito da anatomia dos tecidos periimplantares, dos critérios de sucesso da osseointegração, da avaliação da saúde periimplantar, da etiologia e do tratamento da periimplantite para facilitar a conduta clínica.